COVERAGE OF EXPOSED TIBIA
COMPARISON OF VARIOUS METHODS
DOI:
https://doi.org/10.29309/TPMJ/2010.17.01.1977Keywords:
Tibia, musculocutaneous flap, local rotational flap, cross leg flap, decorticationAbstract
The alarming rise in road traffic accident has resulted in increased incidence of degloving lower limb injuries requiring some sort
of cover for exposed bones e.g tibia. Objective: To study and compare the rate of wound infection & decreased morbidity in degloving injuries
of lower limb following early bone coverage by various surgical methods of bone coverage. Design: Comparative, prospective study, Place
& duration of study. Allied Hospital SU II Faisalabad. Period: From January 2002 to October 2004. Material & Methods: Thirty (30) patients
divided into four groups, muscle & musculocutaneous flaps for 15 patients, local rotational flaps for 05 patients, cross leg flaps & decortication
for 05 patients. The patients in each group were divided unequally because of unavailability of patients. Patients were also examined
postoperatively for 06 weeks. Results: The patients underwent surgery for degloving injury of leg. Most of them were young males
between 5-45 years of age resulting mainly from different types of accidents. 2 out of 15(13.3%) patients having, musculocutaneous flaps
developed wound infection. 1 out of 5(20%) with local rotational flaps, 2 out of 5 (40%) with cross leg flaps & 3 out of 5(60%) with decortication
developed wound infection. 14 out of 15(93.3%) patients with muscle & musculocutaneous flaps while 4 out of 5(80%) with local rotational flaps
recovered within 3 weeks. Patients with cross leg flaps recovered after one month while patients with decortication recovered after forty five
days. 13 out of 15 regained full function (86%) with muscle & musculocutaneous flaps while patients having local rotational flaps regained 100%
full function. 4 out of 5(80%) regained full function with cross leg flaps & 1 out of 5(20%) regained full function with decortication. Conclusions:
Muscle & musculocutaneous flaps for exposed tibia is safe and effective method of treatment having low rate of wound infection with wider
coverage & decreased morbidity.
